Individual ProviderWisam KhouryStudent in an Organized Health Care Education/Training ProgramStudent, Health CarePractice Address9500 Euclid Ave, Cleveland, OH 44195-0001(216) 444-2465(216) 527-8875PECOS EnrollmentBased on the most recent information from CMS, provider Wisam Khoury does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:13 AM.Profile DetailsProvider ID1033493754Provider TypeIndividualFull NameKhoury, WisamTitleDr.CredentialMDGenderMaleSole ProprietorNoEnumeration Date9/29/2011Last Updated9/29/2011Contact InformationPractice LocationPractice Address9500 Euclid Ave, Cleveland, OH 44195-0001Phone(216) 444-2465FaxUnlisted FaxMailing LocationMailing Address2374 Euclid Heights Blvd Apt 204, Cleveland Heights, OH 44106-2736Phone(216) 527-8875FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode390200000XPrimaryDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer